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General NPI Number Information
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NPI Number | 1508990664
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Entity Type | Organization
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Legal Business Name | DEAN BA NGO MD INC
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 05/24/2013
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Provider Practice Location Address
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Address Line | 15606 BROOKHURST ST STE B
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City | WESTMINSTER
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State | CA
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Zip | 92683-7582
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Country | US
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Telephone | 714-531-0000
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Fax | 714-531-1006
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Provider Business Mailing Address
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Address Line | 6426 FAIRWIND CIR
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92648-6714
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Country | US
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Telephone | 714-556-0000
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Fax | 714-556-1006
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DEAN B NGO
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Credential | MD
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Telephone | 714-531-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A50341
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A60674
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License Number State | CA
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